Causes and risk factors
Injury to the ankle bone, particularly ankle sprain which causes tearing and stretching of the ligament and which does not heal completely, leads to chronic pain and instability. The ankle joint is supported by lateral ligaments like anterior talofibular ligament (ATFL), calcaneo fibular ligament (CFL), and posterior talofibular ligament (PTFL). Laxity in theses ligaments caused due to sprain and injury causes chronic ankle instability. This affects the ability to balance. The movements at the ankle are complex involving rolling, rotation, and lateral balancing of the arch. Improper rehabilitation also contributes to the same. Repeated ankle sprain and weak ligaments are other causes. This condition is commonly seen in athletes. A nerve injury, torn ligaments, synovitis along with arthritis of the ankle joint are certain other causes which can lead to instability of the ankle joint.
Clinical presentation:
The complaints can either be unilateral or bilateral. Pain is a prominent feature seen; dull aching pain is felt in the outer side of the ankle. Along with pain swelling, stiffness, and tenderness is felt. The pain is persistent and lasts for a long time. It is aggravated by turning the ankle and walking on uneven surfaces. The patient complains of unstable feeling in the ankle joint with a sensation as if the ankle is giving away. Walking, standing, and even other activities can aggravate the pain.
Investigations:
The symptoms and the history are taken into consideration. A local examination is carried out. In order to confirm the diagnosis, certain investigations are advised. An x-ray of the affected ankle is done. Advanced imaging techniques like MRI and CT scan can also be advised.
Treatment:
The treatment plan depends upon the severity of the complaint. In order to relieve the pain and inflammation, pain relieving medications are advised. Nonsteroidal anti-inflammatory drugs are advised. Corticosteroid injections are given. Wearing of ankle braces are advised. If the complaints are not relieved by medications, surgical intervention needs to be done. For improving the strength and activity of the muscles, exercises are advised under a trained physiotherapist’s plan.
Other modes of treatment:
Certain yoga exercises or physical exercises under a trained physiotherapist will help to strengthen the muscles and ligaments and improve the flexibility.
When to contact a doctor:
Contact an orthopedic doctor if one experiences any pain, swelling, and discomfort in the ankle joint.
System involved: Musculoskeletal system.
Organ involved: Bones, nerves, muscles, ligaments, joints, ankle
